Here Lies Truth

Life imitates satire–and scholarship

Over at Cognoscenti, a blog sponsored by WBUR in Boston, Darshak Sanghavi writes about the problems with meta-analysis of clinical trials. I agree with the basic principle that meta-analyses need to be handled with more care than they probably are, but I smiled when I reached the end:

The researchers found the meta-analyses would have led doctors to adopt useless treatments one-third of the time, and to reject helpful therapies another one-third of the time. After this debacle, why would anyone take the findings of meta-analyses very seriously?

Second, over at The DNA Exchange, the genetic counselor Bob Resta has written another trenchant reflection on the profession he loves, titled provocatively, “Resistance is futile: a new paradigm for genetic counseling?”. Genetic counseling began as a way to help patients cope with genetic disease (as well as determine paternity and racial membership). Is the rapidly dropping cost of genetic testing leading to a situation in which everyone is a patient? Is this a good thing?

As I write in The Science of Human Perfection, elite biomedicine is indeed leading directly to such a situation. The Dean of Education at the Johns Hopkins School of Medicine said recently that a principal goal of genetic medicine was to identify “latent disease,” and treat it before it starts. When I asked him who, under that scenario, was a patient, he smiled broadly and said, “We are all patients now.” I find this not a little creepy, and so does Bob.

Full disclosure: Bob’s piece concludes with a nice plug of my book and Alexandra Stern’s new history of genetic counseling, Telling Genes (which I plan to review here soon). Aside from whatever nepotism is called when it’s between colleagues, Bob’s piece is important reading.